| Regimental number | 5061 |
| Place of birth | Bombala New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Wyndham, South Coast, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs. E. Cootes, Cathcart, via Bombala, New South Wales |
| Enlistment date | 6 October 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Makarini on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 55th Battalion |
| Fate | Returned to Australia 19 February 1919 |